THE RESEARCH OF BRADYCARDIA AND HYPOTENSION INCIIDENTS RATE DURING EPIDURAL ANAESTHESIA IN PATIENTS UNDER THE GENERAL AND ORTHOPEADIC SURERY

ABSTRACT

Background: it was decided to make a retrospective study about the frequency and value cardiovascular events (hypotension and bradycardia) and correlation between potential relevant risk factors during perioperative period of patients who underwent epidural anaesthesia during general and orthopaedic surgery.

Methods: 48 patient were randomly included in general surgery and 74 patients in orthopaedic surgery groups. General surgery group (GG) received standard general-epidural anaesthesia and orthopaedic surgery group (OG) received standard spinal-epidural anaesthesia. Results were analysed by surgery type. Observed conditions which increase rate of cardiovascular complications: age <65 and ≥65 years, chronic diseases, cardiovascular diseases, ASA physical status.

Results: in GG (48) was 22,9% patients with bradycardia and 12,5% patients with hypotension, in OG (74) was 24,3% patients with bradycardia and 13,5% patients with hypotension (p>0,05). In GG was 63,6 % ≥65 age patient with bradycardia, hypotension in GG occurred to 66,7% ≥65 years patient. In GG 81,8% patients with bradycardia had chronic diseases (p<0,05). Hypotension data: 83,3% patients had chronic diseases (p<0,05). There was 72,7% of those with bradycardia had cardiovascular diseases (p<0,05); it was 83,3% of those with hypotension had cardiovascular diseases (p<0,05). In OG was 61,1% ≥65 years patient with bradycardia, hypotension in this group occurred to 60% ≥65 years patient. 77,8% patients with bradycardia in this group had no chronic diseases. Hypotension data of OG: 70% patients had no chronic diseases. There was 77,8% of those with bradycardia had no cardiovascular diseases; it was 80% of those with hypotension had no cardiovascular diseases. The most common ASA physical status among patients with both bradycardia and hypotension episodes in GG was ASA-3 (81,8%), while in OG the most common was ASA-2 (66,7%) physical status.

Conclusions: the rate of bradycardia and hypotension in both groups statistically insignificant. The risk factors had significant influence in general surgery group. Patients in the general surgery group who experienced bradycardia and hypotension events often had more severe ASA physical status (ASA 3) than patients in orthopaedic surgery group (the most common was ASA 2) and that could be the reason of greater significant risk factors influence in general surgery group.